揿针疗法对门静脉高压症脾切除断流术后胃肠功能的调节作用  

Therapeutic effect of needle-embedding therapy on regulating gastrointestinal function after splenectomy and devascularization for portal hypertension

作　　者：杨林青 任松 纪泛扑[2,4] 张健 蒋安[2,3] 张丽 安鹏[5] 王林 李宗芳[2,3] Yang Linqing;Ren Song;Ji Fanpu;Zhang Jian;Jiang An;Zhang Li;An Peng;Wang Lin';Li Zongfang(Nursing Department,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China;National and Local Joint Engineering Research Center for Biological Diagnosis and Treatment,Xi'an 710004,China;Department of General Surgery,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China;Department of Infectious Diseases,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China;Department of Chinese Medicine,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学第二附属医院护理部,710004 [2]生物诊断治疗国家地方联合工程研究中心,西安710004 [3]西安交通大学第二附属医院普通外科,710004 [4]西安交通大学第二附属医院感染科,710004 [5]西安交通大学第二附属医院中医科,710004

出　　处：《中华肝脏外科手术学电子杂志》2023年第3期322-326,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：陕西省重点研发计划项目(2020SF-298)。

摘　　要：目的:探讨揿针疗法对门静脉高压症脾切除断流术后胃肠功能的调节作用。方法:本研究对象为2018年10月至2020年12月在西安交通大学第二附属医院行脾切除断流术的92例肝硬化门静脉高压症患者。其中男53例,女39例;年龄29~70岁,中位年龄52岁。患者均签署知情同意书,符合医学伦理学规定。按照随机数字表法随机分为揿针组(46例)和对照组(46例)。对照组仅接受常规治疗,揿针组给予常规治疗和揿针治疗。两组术后首次排气、排便、进食时间等比较采用t检验;术后恶心、腹胀程度视觉模拟评分法(VAS)评分比较采用秩和检验;低钾血症发生率比较采用χ^(2)检验。结果:揿针组平均术后首次排气、排便、进食时间分别为(52±15)、(92±20)、(48±12)h,明显短于对照组的(62±11)、(103±21)、(59±12)h(t=-3.556,-2.640,-4.328;P<0.05)。揿针组术后2 d恶心和腹胀程度VAS评分中位数分别为0(0)、0(0)分,明显少于对照组的0(1)、0(2)分(Z=-2.401,-2.571;P<0.05)。揿针组术后4 d低钾血症发生率为13%(6/46),明显低于对照组的35%(16/46)(χ^(2)=2.431,P<0.05)。结论:揿针疗法能促进肝硬化门静脉高压症患者脾切除断流术后胃肠功能恢复,降低术后低钾血症发生率。Objective To evaluate the regulating effect of needle-embedding therapy on the gastrointestinal function after splenectomy and devascularization for portal hypertension.Methods 92 patients with cirrhotic portal hypertension undergoing splenectomy and devascularization in the Second Affiliated Hospital of Xi'an Jiaotong University from October 2018 to December 2020 were enrolled.Among them,53 patients were male and 39 female,aged from 29 to 70 years,with a median age of 52 years.The informed consents of all patients were obtained and the local ethical committee approval was received.According to the random number table method,the patients were randomly divided into the needle-embedding therapy group(n=46)and control group(n=46).Routine treatment was given in the control group,and routine treatment combined with needle-embedding therapy were delivered in the needle-embedding therapy group.The time to first flatus,defecation and eating after surgery was compared between two groups by t test.The visual analogue scale(VAS)scores of postoperative nausea and abdominal distension were compared by rank sum test.The incidence of hypokalemia was compared by Chi-square test.Results In the needle-embedding group,the average time to first flatus,defecation and eating after surgery was(52±15),(92±20)and(48±12)h,significantly shorter than(62±11),(103±21)and(59±12)h in the control group(t=-3.556,-2.640,-4.328;P<0.05).In the needle-embedding group,the median VAS scores of nausea and abdominal distension at postoperative 2 d were 0(0)and 0(0),significantly lower than 0(1)and 0(2)in the control group(Z=-2.401,-2.571;P<0.05).In the needle-embedding group,the incidence of hypokalemia at postoperative 4 d was 13%(6/46),significantly lower than 35%(16/46)in the control group(χ^(2)=2.431,P<0.05).Conclusions Needle-embedding therapy can promote the recovery of gastrointestinal function after splenectomy and devascularization and reduce the incidence of postoperative hypokalemia in patients with cirrhotic portal hypertension.

关 键 词：肝硬化 高血压 门静脉 脾切除术 断流术 胃肠功能 揿针疗法 

分 类 号：R657.3[医药卫生—外科学]